Update on Recovering

Today, I am roughly at a month and 2 weeks from my heart surgery. In some ways, I am looking back and I cannot believe how far I have come (I am not in a hospital bed, wired and attached to machines with everyone doing everything for me), and in some ways, I cannot believe I am still recovering and re-learning to do the easiest things daily (like putting on my socks and shoes).

A month and two weeks is hardly enough to get back to who you were before – I have learned this every day since then. One of the Rehab Center techs told me my body “was assaulted like never before” during this surgery, and trust me – this is exactly how it feels.

I still go through the pictures of all the scars and wounds and bruises I left the hospital with, just to remind myself what I am pulling myself from and to encourage me that change is happening and I am doing better. Some days, the hard ones, it is hard to remember this.

I have found a routine for my recovering weeks, and it usually goes like this:

• during the week, I wake up and after shower and breakfast, I go to rehab in the early morning – my husband is still driving me, because I am nervous to be on the highway with my upper body hurting from steering and with the seat belt not in the right place - I wear it under my left arm, because it hurts my chest;
• I come home and I snack – those exercises take away all my breakfast;
• Sometimes, I take a light nap or I catch up on email or the news;
• Then, I either read, or do some sitting down work/ crafts (mostly something I can do with my right hand) or I do house chores; I can't do strenuous ones (like vacuuming and cooking pots of food, or taking the trash out), but I put (small) dishes away, I dust, I put away clothes that have been washed, or clean up the cat's corner, etc;
• In the afternoon, after lunch, I either walk on my treadmill, or walk around the neighborhood, or lately, I have been going to a store and walking around there with my mom and my husband; my mom has gone back home now, so it will be harder to find excuses to go to the store often in the afternoon;
• Then, it's dinner time, and watching some tv;
• I try to stretch and do breathing and arm strengthening exercises all throughout the day; I am weak everywhere, but my arms feel it the most.

I have not been able to cook much yet. I made some hashbrowns in the oven the other day, and I reheat a lot of stuff, but I cannot peel a potato, or lift a pot of water of more than 1 qt from the sink.

I drove just around the neighborhood pretty much today, for the first time, and I was out of breath by the time I got to WalMart which is like 3 minutes away from my house. The steering wheel feels like it has no power steering at all, and it hurts my chest with every move. Plus, the “adjustment” I made to my seat belt does not hurt less, it just hurts in a different place – my left arm, instead, which is numb to begin with. I am definitely in no shape to start driving to work, which is at least 30 minutes away with no traffic, one way, all highway driving. I am not venturing on the highway yet.

Other than my weekly INR checking appointments, I have not had any other appointments lately. I am also blessed and every so grateful that I have not landed in ER or any other “unexpected” appointment yet.

The INR is a slippery, tricky beast, though, in itself. My target for now is 2-3. I have been fine … till last week when I decided to introduce leafy greens and broccoli to my diet, and boom! It tanked at 1.8. So, now, they increased a dose a little, only one day a week. I have no idea how it all works for them to decide which days to have 2 mg of Coumadin on and which days to have 1.5 mg, but this is what they do... They alternate the dose and spread the higher ones out through the week. It's OK for now to have the INR all over the place, because I am still learning what to eat, what affects it and how to be consistent about eating it, so I can balance the INR. Until then, weekly checks is what's needed.

I have gotten a phone call from my disability insurance to interview me and check whether “I am still sick”, basically. As much improvement as I have seen since leaving the hospital, I still cannot tell you that I have the stamina, and the strength in my body to resume work yet.

I am tired most of the time, even with a slightly easy schedule (above). I cannot muster more than 2 hours tops out of this house, and after that I must sleep and lay down for the rest of the day. I don't go out of breath from showering anymore, or washing my hair, but I still am completely done for the day after rehab in the morning (an hour or so) and a similar workout in the evening. And I don't trust myself to drive yet – which is a big part of my working life.

Another big part of my work life is typing – and with my numb and painful left hand, this is a challenge. I correct my misspellings all the time, because my typing is poor with my left hand.

My left arm is completely numb and very painful. All. The. Time. I can carry my purse, which is about 3 lbs, but I would not be able to even lift my work bag, which has my laptop in it, and my entire contents of my purse, not just the “abbreviated” ones I have now. I am thinking because of my upper body strength being so weak still, my back still hurting, my ribs, too, and because I am not gaining weight at all, I will have to use a dolly to carry my work bag and my lunch bag, when I do go back to work, for a long, long time.

I know you are wondering what can be so heavy to lift in a 2 qt pot and a 15 lbs (or maybe more?!) computer bag?! But I weigh 95 lbs right now. 15 lbs is more than 10% of my body weight, so to me, with no muscle mass to speak of, and just bones, and with the arms depending on the still cracked and healing sternum for support, this is a huge deal.

My incision is almost all healed, except for two spots which are still scabby. I still have a huge scab in the bend of my left knee, where they harvested the vein from. The left leg is numb but not as painful as my left arm.

I am getting there, albeit slowly. I am still paranoid about catching the flu or pink eye or something from the huge children population of my state, so I keep my visits to public places limited. I do have people visiting me, though, and I eat out maybe once a week – although I choose my restaurant carefully (cleaner, less kids, perhaps?!).

I am still uncomfortable sleeping – I don't see this changing any time soon. I am still learning a lot about Coumadin and my new life with it.

My blood pressure has been very low lately! Even with exercise, the last two times I went to rehab, it's been around the 108/35 range. Even after 40 minute 2.8 miles/ hour walk (I have small feet and short legs, so this is like running to me!), the blood pressure sits stubbornly at 110/45 or something crazy like this. I asked the rehab nurse and my cardiology nurse whether this is a problem, maybe my beta-blocker dose needs to be lowered, now that I have a “different” heart, but they insisted that if I am not lightheaded, then it's OK. So, I am keeping the 100 mg dose of atenolol that I have taken for 15+ years now.

I also asked about why being so tired all the time and why not assimilating anything I eat to gain some weight – they said all this is normal post-surgery fatigue, it will go away with time and patience and they said all that I am eating now goes to healing my body, and not to increasing my weight.

I am back on my vegan diet, because the animal protein I was trying to eat to increase my hemoglobin and address my anemia has made me sick (hives and GI issues). I am sticking just with fish (tuna and salmon mainly) and vegan meals. I do eat and the taste for food is mostly back, but for some reason assimilation of all I eat is the problem.

And that's what's new in the heart surgery recovery corner. Spring is slowly coming and I hope to move most of my exercise outdoors, whether I'll prune my roses or walk in the neighborhood to peek at neighbor's yard improvements. My sister and older nephew are coming to stay with us for a week, and I hope to take him to parks, to the aquarium, to a mall (not all of them in the same day, mind you!), so that will give me a reason to walk, too. One day at a time and one foot in front of the other is all I know, right now.

The short disability insurance person asked me how long do I think I will need before being completely ready for work – it's really just like asking someone how long do you think you're going to live. There is no telling. Days are sometimes good and some are really bad. Some days, I wake up in the middle of the night grabbing for a Tylenol, but wishing it was a Percocet, and some nights I can grind my teeth and end up just sleeping through the pain. I wish I knew what my body decides to do every minute, but it's like a crystal ball.

A Light One, for a Change

I haven't posted one of these in a while. Open heart surgery gets you distracted like that!

I wanted to share a 100% vegan and so surprisingly yummy dinner combo I made up tonight. Everything is soy free, as well. 

I buy these vegan Marsala burgers at Trader Joe's which are super good, and not too bad for you (0.5 sat fat and 0 trans fat and cholesterol). So I warmed one of those up, then I made a side of cheesy grits with just half a teaspoon of vegan "butter" and half of a teaspoon of vegan cheese, salt and pepper, and then my mom made what I call Romanian coleslaw - it's chopped cabbage and just balsamic vinegar, salt and pepper. 

I was dubious of the combo but it turned out like a complete meal and very delicious to top that. 

The finished meal 

Not a Bicuspid Valve, After All

So, here’s the story: about 6 years ago I lived in North Carolina. I had seen this cardiologist for about 10 years at that point and I absolutely worshiped him. He took good care of me, and, to my knowledge, he took good care of my heart. He did all the right tests, kept me on the right meds, sent me to a doctor in pharmacy to manage my nutrition and drug regimen, the works. 
But he never ever said once (after doing an echo of my heart almost every year) that I had a bicuspid aortic valve (which should be there since you were born). 

About 6 years ago, I moved to Utah. I had to get a new cardiologist. About the second year I saw him, he said for sure I have a bicuspid aortic valve that is shrinking and at some point I’d need surgery. I started doubting my long time worshiped North Carolina cardiologist, because how in the world did he ever not see my congenitally modified and bad valve?! He did tell me about the heart murmur, and bruits in my carotid arteries, but never about this anomaly of my valve. Why?! How could he miss it for 10 years?! He went to Harvard, for crying out loud?! 

In the past 6 years, my so called bicuspid aortic valve continued to get bad, until this year, when you know what happened (http://livingwithfh.blogspot.com/2015/12/and-now-we-wait.html). 
Fast forward a few months later, till yesterday when I met with my heart surgeon, after a month from surgery. 

My pushy and annoying curiosity kept asking the surgeon very specific questions about my surgery - just tactical, specific ones. So, he finally printed my entire operative report and gave it to me, to easily answer my morbid curiosity. 

And to my huge surprise, it’s written quite clearly all over it that what the surgeon replaced inside my heart was a “tricuspid aortic valve with two leaflets joined together with severe calcification”. He writes there how only one leaflet was working, and the other two were glued together and immobile. 

So many things and questions came through my head:
First off, my North Carolina doc was not wrong - probably, at that time, my valve was visible as a tricuspid valve (which is normal), so no reason to alert me of anything
Then, how can so many echos done here in Utah, for 5 years now been wrong? They did MRIs and CT scans and even an angiogram. Not ONE of them could show the difference between a bicuspid valve and a atherosclerotic tricuspid one? 
How can these very advanced tests that we trust so much not be able to tell the difference? 
Well they didn’t. 

Sure, the final outcome was good - we got the valve repaired (regardless of the reason of how we got there), along with everything else, but the final diagnosis was just: CAD caused by FH. All the damage, whether in my valve, my aorta, or three of the coronary arteries were all caused by what I knew since I was 6 that it’s killing me slowly: cholesterol.  

You know, almost 35 years after being diagnosed with FH, there is not one year without surprises in this disease. Either good ones, or bad - they’re all there. You’re always on your toes and always learning something new about your body. 

The 'Cannot Do' List, after a Month and a Bit from OHS

A lot of people have sent me many messages saying things like “I am so happy you’re this advanced/ progressing so well/ this far into your recovery so successfully”, etc. I REALLY appreciate this, I really do. But, honestly, I still feel like I am lagging many, many weeks behind, and I am slow as a sloth, compared to my “before” self. 

Also, some people with my condition facing surgery ahead are wondering how fast the recovery goes. I cannot speak in general, of course (who can?!), but I can speak for myself. 

For these reasons, I thought of putting together a quick list of what I cannot do by myself yet, at a couple of days after my one month anniversary: 

-I cannot tie up my shoes
-I can’t very much bend to the floor, for some reason, so I can’t do anything like picking stuff up, or feeding my cat 
-I cannot open heavy glass doors (especially sliders), or sometimes freezer or fridge doors
-I can’t chop, cut meat, or anything heavier than bread
-I can’t wash plates, pots, anything in the sink, nor can I lift pots full of food; my husband and my mom do all the cooking because of these reasons
-I cannot change the toilet paper in the holder - those springs are so tight for me
-They tell you “you can lift up to 8 lbs” after surgery, but I think this is a myth: this should be in accordance with your body weight. If the 8 lbs is a generic number, and you are a 300 lbs man, my number should be “slightly” lower at 97 lbs. Anywhoo, I cannot lift my purse without pain in my chest, any it’s about 4 lbs heavy if that. 
-I can’t drive - and I won’t be cleared for it till I do some upper body strength training at the cardiac rehab center, and I have not been cleared to start that yet. 
-I misspell words that require letters typed with my left hand; I have to go back and correct them often. My left arm is completely numb.
-I tire easily - I can walk for about 45 minutes max, slowly, and then I am done for the day. If I wash my hair in the shower, I am done for about 6 hours. It exhausts me! 
-I sleep poorly and eat poorly, too. I cannot sleep on my side, still. 
-Outside my arm and leg which are totally numb, I still have a very “burned” back - the skin on my back feels cigarette paper thin and hot, which makes it extra hard to sleep solely on the back. It’s like sleeping on timbers. 
-As far as scars go, I have thick, painful scabs still on several scars: on my incision (6.5 inches), my two insertion points on my left leg where they harvested my vein for my bypasses, and a couple on my stomach where my drainage tubes went in. 
-Days are uneven: I took 2 painkillers yesterday, all day, but I’ll probably take at least twice as much today, and that’s just to numb the pain, not to make it completely gone. 
-I can’t work screw caps and lids.

I am grateful that I can walk about the house and I am not bedridden, and that my mind is back to being clear, so I can read and keep up with friends and family and keep my medicines straight myself. Most than anything I am grateful I am ticking, still. 
I am grateful for all the small things I can do by myself, too. But there is a long way to go, still, till I feel like a full person again. With patience and time, I hope to get there one day soon.

New Numbers Under Duress (sort of)

So, what does cholesterol do under the pressure of heart surgery and heart surgery recovery? Well, mine goes way down (for me), apparently, with a dangerously low HDL (as you can see below). 

These were not fasting labs, and every time they take my blood in the afternoon, my triglicerides end up being higher than usual. 

My appetite has been bad since the surgery - some days all I can muster is toast and grits for all of the meals (don’t worry, it’s all vegan and low fat).

But I have squeezed in some “bad” (for me) meals since the surgery, like Boost (I usually hate shakes), yogurt, cream cheese and bagels, and turkey, just to get some protein in me, as my red blood cells are low, still. These are mostly meals I ate in the hospital. I still eat some turkey at home, as it’s one of the few meats I am not as intolerant to as all others.

I wish I can tell you that the drop in the numbers is the result of some magic diet, or medicine regimen that I am proud of, but I think it’s just a drop because of everything else happening in my body, medicine, stress, and all.

I am just puzzled about my HDL. If I can know the magic food to take to make it at least at the low limit again. Oy. It’s always something.

When I am further up into my heart surgery recovery, my cardiologist will start (my budget affording!) the regimen with the PCSK9 drug (not sure which one yet). That would be the next step in my FH therapy. For now, we’re just focusing on recovery and getting stronger, and making sure the repairs in my heart actually really work well.

I am taking all the meds I used to take prior to the surgery, including the aspirin (people on coumadin usually stop aspirin). The only difference is that my cardiologist moved the dose of aspirin from 325 mg to 81.

The one thing I did add was the supersized dose of Vitamin D because of my “dangerous deficiency” - not sure if that could affect HDL in such a fashion, though.

We’ll keep on ... moving on. No other choice, of course.

Slow and Steady Progress

Thank you, all, for following my progress here, or just for following the life of an FH and heart patient, as well. It’s really humbling to see that some of you find this helpful and that some of you are just keeping a hand on my pulse. Thank you, all.

I wish I had another huge milestone to post about, but for the past week or so, the days have gone pretty much in similar fashion: in the morning, we wake, we eat, my husband drives me to rehab, I do my treadmill walk (every day is longer and faster than the one before).

Some days, we have a couple of other doctors’ appointments or classes to go to, then we get home. We eat, I sometimes nap (I try not to, but some days are harder than others), and then we putz around the house. Well, he does and my mom, I mostly read, surf the net till I feel brain dead and chat with my cat a lot.

I have seen my cardiologist several times so far, and he asks me every time when we can start the PCSK9 shots, to really make a dent in the cholesterol numbers. So, with FH still very much in the picture (it’s mostly what caused this whole surgery in the first place), he’s definitely keeping my focus steady on that main  root cause. I love him for it, but I am not ready to think about anything else but recovering and feeling like a functional human again. We did talk some this last time about the shot, the results, and how it would affect the damage already done in my body - this is subject for another post, but things seem to look promising.

I sometimes (weather permitting and my own energy allowing) take a walk around the block which always makes me feel like a marathon winner. You gotta understand, if you are me and have been looking in the mirror naked (pardon the visual) for the past 3 weeks, and are seeing the countless scars and bruises and cuts and swollen spots, and blisters from band aids, and broken veins, not to mention the stuff you DON’T see, that they did on the inside of my body (the artificial stuff they implanted, the stitches for every one of those, the new connections to allow my blood to flow, the artery pulled out of my chest, the vein pulled out of my calf) and so forth ... you would feel like a marathon winner, too, after walking a mile in 30 minutes!!

Some days, every day, actually, I wonder at the miracle of life and willingness to live we have in us, and I marvel that I am still breathing and walking up straight. Big miracle. Very grateful over here.

Today was supposed to be the day where they “graduated” me at rehab, from just cardio walking (treadmill) to strength training - where they make you lift weights and pull at tight bands to make your upper body strong. I filled out an evaluation yesterday to see if my surgeon will approve the graduation and the papers were not back from the surgeon today. Anywhoo - the nurse decided I was ready for the strength training, so she sent me to do it anyway. Well, the strength trainer definitely gave up on me and very clearly said I was not ready for this, after a couple of exercises where I was screaming (figuratively) in pain from my chest killing me.

So, this is what’s odd: after OHS, your whole body will hurt like hell. Your ribs and your back hurt the worst for me right after surgery (they told me, “the tubes in your chest” are to blame), but comparing to that pain, the chest (where the surgery is!) didn’t hurt too badly. Well, NOW, almost a month later, tube free, the chest is what’s killing me. And my upper back.

The strength training is supposed to restore your upper body strength - so, that’s not gonna happen till my incision and my chest plates will stop screaming. They can be tight, but they can’t hurt. And I still take OTC pain killers, so ... they should not make me want to cry when I pull an elastic band from the floor to the shoulder.

Some days are good days - I have energy and I can work through small chores, with lots of breaks, around the house. Some days, all I want to do is lay down and sleep, in knots of pain all over my body. I know that’s not allowed (day sleeping), because then, at night, I suffer.

And that brings me to my least favorite subject, really: almost a month after surgery, I still have not figured out a way to sleep at night (just a position, or a seating arrangement that is comfortable). Every morning, I wake up more beat up and sore than ever! I asked at the clinic, and everyone shrugs: you’re supposed to find your own sweet spot for sleeping, they say, but I have not found mine yet. I am not a back sleeper and to sleep on my back the whole night, without moving is killing me.

So, in a nutshell, what can you expect after open heart surgery, and after going home? Here’s a quick and dirty list:

• lots of drug balancing - I am off the narcotics, but still going in weekly for balancing out the coumadin
• lots of sleep weirdness and trying to find out the “new comfy sleep position” that will get you some rest
• lots of pains, aches, and lots of just “discomfort” - you will need to know the difference and qualify it for the medical staff: they want to know exactly what hurts vs what is just tight, or just “in the way” - you will get to know your body very intimately
• along the same lines: you might have some numbness somewhere, because this surgery will damage nerves (mine is left arm and left leg and chest); it’s different for everyone; you’ll learn to use less of your body for a while, because of this
• weird stuff will happen, almost surely: I have had hallucinations and double visions, along with light headedness
• have someone with you at all times - putting on your shoes might be impossible, if you wear something with laces
• go to rehab often and have patience - on my first session (8 minutes on treadmill) I never thought I’d walk on a treadmill for half an hour with an open sternum, but here I am. Your body will come back, slowly.
• lots of doctors’ appointments (surgeon, cardiologist, labs) - they keep making sure what they did actually works on the inside; there is still some things as “silent killers” even after OHS
• if you can focus, have some good entertainment around you - books, TV, Netflix, easy crafts, whatever - you WILL be bored when you’re awake and finally starting to make sense of your world
• nap, but shortly
• food might not be your friend for a while - this takes different forms, for all of us; for me: it ALL tastes wrong and for the most part, it all makes me want to throw up. I lost 8 lbs in less than 3 weeks, and at around 100 lbs that’s a lot to be losing in a short time. Force yourself to eat, though (duh!, right?!). My appetite and joy for food is not back yet, at almost a month.
• stay in touch with your support group - they will be the fuel you need to push you forward.
• if you have a loyal pet, all the better - they know what’s going on and will give you a reason to wake up in the morning as well as cheer you on.

Much health and thank you, to all of you.

Not a Competition

You know what?! Just like everything else in life, heart surgery and heart surgery recovery is pretty much the same thing, in my opinion: NOT a competition. I can see the eyes of at least my best friend rolling in her head right now and  saying in her mind, "Oh, boy. EVERYTHING is a competition, otherwise it ain't worth getting outta bed!", but in my little corner of the world, everything is not a competition. 

We are put on this planet to do our best - true statement. We are put here to give it our all - true again. But we are not put here to compare our faster with someone else's faster, or our longer with someone else's longer - if we do this, I feel, we already lost. And I don't want to feel like a loser. 

Recovering from heart surgery will teach you this easily: you'll read about people recovering in a month. In three weeks, even, and you're at week 3 and you can't tie your own shoes and what are you supposed to do?! Jump out the window? No - because just like we each eat slower or faster, more or less, we run or we walk, we get over a cold in a week or five, we like our coffee cold or hot, we're ALL different. Our bodies are all different. We have different surgeons and every procedure is different - we will all have a unique healing curve and whatever that is for us it is our curve! Sure, if in two years, we're still bed ridden from open heart surgery, there is a problem and a doc should figure out what it is. But if you walk 2 miles on a treadmill after 3 weeks and the dude next to you walks 3.5 after 4 and he's 20 years older than you, it's just what it is. 

Again, going back to my yoga roots, I try to not put judgement to it, and just focus on my breathing, my time, the way my body feels in the moment. I loved one of my yoga teachers that used to say "You know what, my downward dog is where it is today. It's not the best I've done, it's not the worst. It is where it wants to be today". We learn from it, but we won't make a judgement about it. 

And we put one foot in front of the other and we keep at it every day. Progress will happen, if we show up and stick with just doing our thing. 

I know - long rant to say, well, maybe my progress is not as fast as others'. But I am happy - it's all that matters. For the most part, my body is pretty mobile (sitting on my couch, legs under me, laptop on my lap, typing right now), I only have a pillow behind my back for back support and that's that. My left arm is still numb, but I am fully typing with all my 10 fingers, numb and all. I had days where I could not lift my glass of ice water as it was too heavy for my chest - not anymore. I did 35 minutes of treadmill today, and my diastolic pressure is finally in the upper 50's and 60's and not in the gutter (20's) anymore. There is small progress, but it's my progress. I'll get there. One day. At my own pace. 

If there is one promise to make to myself is to not compare myself with others and just focus on me. On my body, on what it wants and what it needs and to give it to it so it will carry me through these changes. 

Eating is still a bit of a struggle, as nothing really sounds good ... We're having stir fry (don't worry, no oil, all healthy veggies, in a wok) for dinner and we'll see how that will affect my INR (https://en.wikipedia.org/wiki/Prothrombin_time) tomorrow - it usually should take days for diet to affect INR, but not in my case - changes in diet and coumadin doses affect me right away - another proof that we're all different. 

A Great Milestone!

Before the surgery, I read a lot all over the internet about people's experiences with open heart surgery. I was mostly interested in the personal accounts of patients, their first hand experiences, the "how does it really feel", and "what does it really look like" from the very shoes of a heart patient. 

In almost all the accounts, everyone talks about the "chest tubes". They leave these drainage tubes hanging out of your torso, through which liquid and blood from surgery will drain for a while. And for some people, this "while" can be pretty long (about 5-6 weeks). 

Everyone talks about the chest tubes because they are painful! I am 19 days since surgery now (hard to believe) and today the last tube came out. It's the first day when I can really yawn and burp freely, without feeling like someone puts the brakes on me every time I open my mouth. Although the place where the tube was is still leaking and I have to baby it for two days (no water, change dressing at least daily, etc), I feel free, literally. Like whatever they did to my heart is finally on its own, and my "new" heart can start working on its own (that happened the day of surgery, I am sure, but today is like Pinocchio lost the strings and can move alone without Geppetto deciding where ... ).

Recovery is still underway, and nowhere near done - but it's also rewarding to hit a long awaited milestone. I can breathe finally deeper, which will mean building more stamina during my rehab and building a stronger core every day - thank God. 

There are other hurdles, still, from recovering during this time. I am losing weight quite fast - could be because of the diuretics that help to eliminate the extra fluid, or could be the lack of appetite, or a combo of both. I tried  to eat some meat yesterday (at the advice of my nurse, to eat as much protein as I can), but my body went into hives for the first time since surgery - remember my protein allergy? Yeah, the surgery didn't fix that. 

There is the numbness in my arm and leg, the permanent cold all over my body, still some fog from my leftover narcotics (trying to stop them today and replace them with just Tylenol) - but overall, I feel like, one foot in front of the other, will eventually get me close to where I was before February 11, minus the ticking bomb in my chest.

For today, I am grateful for yawing freely. A small perk for humanity, I know, a huge step for me.